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Pathology: A Career in Medicine Brochure

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Administrator/Managing Editor
Donna Stivers
E-mail:
dstivers@asip.org
Phone: (301) 634-7200
Fax: (301) 634-7990

Surgical Pathology

The surgical pathologist plays a central role in the diagnosis of biopsies or of surgically removed tissues, particularly when tumor is suspected, and works closely with surgeons and other physicians in such cases. Nonsurgical endoscopic methods often are used to examine the airways and the gastrointestinal tract. Using a flexible scope the physician can examine the lining of the airways or of the stomach or intestines. Biopsies performed during such procedures produce very small samples of tissue. Nevertheless a great deal of information often can be obtained from them by the pathologist, including specific medical disease or tumor diagnoses.

Surgical removal of tumors often results in complex specimens that require detailed examination by the pathologist. The surgical pathologist is trained to identify evidence of disease at the macroscopic as well as microscopic level. Knowledge of typical gross abnormalities and an understanding of the information that is important for patient management (such as the status of resection margins) guides the pathologist in selecting tissue samples for examination under the microscope.

Often during surgery for suspected cancer, a pathologist is asked to prepare a frozen section. A piece of tissue is removed during the operation, frozen, thinly sliced, and prepared for rapid microscopic examination by the pathologist while the patient is still on the operating table. The preliminary diagnosis based on the frozen section guides the surgeon as to the next steps to take during surgery.

A complete pathologic work-up of tissue specimens increasingly requires correlation of histologic findings with molecular alterations. For instance, certain molecular studies may be essential to confirm the diagnosis of a histologically undifferentiated tumor, or to identify whether the patient is a candidate for therapy directed to specific molecular targets.

After the pathologist fixes the patient's tissue samples the specimens will be thinly sliced, mounted on slides, and examined under a microscope.